Bilateral facial pain
Professional Reference articles are designed for health professionals to use. You may find the Trigeminal Neuralgia article more useful, or one of our other health articles. NICE has issued rapid update guidelines in relation to many of these. This guidance is changing frequently. Facial pain has a long list of possible causes but the diagnosis can often be made by a good history and examination.
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The diagnosis and management of facial pain below the eye can be very different dependant on whether the patient visits a dentist or medical practitioner. A structure for accurate diagnosis is proposed beginning with a very careful history. The commonest acute causes of pain are dental and these are well managed by dentists. Chronic facial pain can be unilateral or bilateral and continuous or episodic. The commonest non-dental pains are temporomandibular disorders TMDs , especially musculoskeletal involving the muscles of mastication either unilaterally or bilaterally; they may be associated with other chronic pains.
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These conditions can present with bilateral facial pain pain on both sides of the face , neuropathic pain burning, continuous pain and pain that is not discordant out of proportion to stimulus — like light touch or chewing. Atypical facial pain is generally NOT caused by a blood vessel contacting the trigeminal nerve and, hence, microvascular decompression surgery is not typically helpful. However, numerous treatment options exist ranging from medications to ablative procedures such as radiofrequency ablation and balloon compression of the trigeminal nerve.
Facial pain is common and often the result of headaches and injuries. However, other causes of facial pain include nerve conditions, jaw and dental problems, and infections. Facial pain can originate from a specific area of the face, or it may radiate from another part of the head.